一名患有过敏性紫癜和非闭塞性肠系膜缺血的成年患者。
An adult patient with Henoch-Schönlein purpura and non-occlusive mesenteric ischemia.
作者信息
Oshikata Chiyako, Tsurikisawa Naomi, Takigawa Masakazu, Omori Tomoko, Sugano Satoshi, Tsuburai Takahiro, Mitomi Hiroyuki, Takemura Tamiko, Akiyama Kazuo
机构信息
Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan.
出版信息
BMC Res Notes. 2013 Jan 23;6:26. doi: 10.1186/1756-0500-6-26.
BACKGROUND
Onset of Henoch-Schönlein purpura (HSP) in middle age is uncommon, and adults with renal or gastrointestinal involvement present with more severe disease than do similar pediatric patients.
CASE PRESENTATION
We present the case of a 69-year-old male with HSP who, after treatment with steroids, cyclophosphamide, and continuous intravenous prostaglandin E1 (PGE1), died as a result of severe gastrointestinal involvement with non-occlusive mesenteric ischemia (NOMI). Vascular narrowing associated with the NOMI improved after catheter injection of PGE1 and prednisolone, but the patient died of bleeding from an exposed small vessel. At autopsy there was no active vasculitis in the jejunal submucosa.
CONCLUSION
Treatment with PGE1 and prednisolone might improve small-vessel vasculitis associated with NOMI.
背景
中年过敏性紫癜（HSP）发病并不常见，且有肾脏或胃肠道受累的成年患者比类似的儿科患者病情更严重。
病例报告
我们报告一例69岁患过敏性紫癜的男性患者，在接受类固醇、环磷酰胺和持续静脉注射前列腺素E1（PGE1）治疗后，因严重的胃肠道受累伴非闭塞性肠系膜缺血（NOMI）死亡。在导管注射PGE1和泼尼松龙后，与NOMI相关的血管狭窄有所改善，但患者死于暴露的小血管出血。尸检时空肠黏膜下层无活动性血管炎。
结论
PGE1和泼尼松龙治疗可能改善与NOMI相关的小血管血管炎。
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